2016 Update: A Lasting Solution for Healthcare in Mozambique

Mozambique highlighted on a map of Africa There is a critical shortage of practicing doctors and medical educators in Mozambique, where the life expectancy is less than 42 years and the rate of HIV infection in adults is 16%. UC San Diego is teaming with the nation’s flagship medical school to create a long-term solution.

Mozambique’s Universidade Eduardo Mondlane (UEM) and UCSD have won a five-year, $12.5-million award from the U.S. Medical Education Partnership Initiative (MEPI). The project will strengthen the nation’s medical education system by building infrastructure in several ways.


“We hope this will be a demonstration project for the rest of Africa.”
— Dr. Robert Schooley


Dr. Emilia Virginia Noormahomed, a co-investigator on the UCSD-UEM MEPI project.UEM’s principal investigator is Emilia Virginia Noormahomed, MD, PhD, a former dean of the UEM School of Medicine. Dr. Noormahomed (pictured at left) is now Assistant Professor of Parasitology at UEM and Assistant Professor of Medicine at UC San Diego.

Sam Patel, MD, Professor of Medicine at UEM and UC San Diego, is a co-investigator. In the photo below, he is pictured on the right.

View photo captions and credits

Dr. Bill Detmer, at left, demonstrates iPad mobile digital device preloaded with medical programs for doctors’ use in the hospital. Dr. Manuel Joaquim Tomás is at center and Dr. Sam Patel at right. Sam Patel, M.D., co-investigator on the MEPI project, is Professor of Medicine at UEM and UCSD. Bill Detmer, M.D., M.Sc., a MEPI project consultant, is Assistant Adjunct Professor of Clinical Informatics at the University of Virginia and President and Chief Executive Officer of Unbound Medicine.

MEPI is a joint initiative of the National Institutes of Health and the President’s Emergency Plan for AIDS Relief (PEPFAR). Under the MEPI program, UEM receives the bulk of the funding and uses it to build capacity in medical training, research, and technology.

A smaller amount of funding comes directly to UC San Diego, supporting time and travel for the partners and mentors who will help UEM meet its goals.

M. Wilson Tilghman, M.D., UCSD’s on-site faculty member in Mozambique, consults with a UEM internal medicine resident at a patient’s bedside. Instituting the use of wirelessly-accessed medical reference material in the hospital is one of the UCSD-UEM project goals.“This is an experiment in medical education for UEM and for the U.S. government,” said Robert “Chip” Schooley, MD, who is coordinating the UC San Diego side of the project. “It puts the funding into the hands of the African universities and allows them to invest it in ways that are beneficial to them.”

Dr. Schooley is Professor and Academic Affairs Vice Chair in the Department of Medicine and Chief of the Division of Infectious Diseases.

“I’m hopeful this will become a model for other kinds of aid,” he said.

Dr. Schooley and colleague Constance Benson, MD, have long experience in partnering with Mozambique and other African nations, and they have collaborated with Dr. Noormahomed in research projects for several years. Dr. Benson is Professor of Medicine, Director of the UC San Diego Antiviral Research Center, and Director of the Fellowship Program in Infectious Diseases.

The UEM-UCSD MEPI project expands some of the educational efforts that have been going on since July 2009 in the Internal Medicine Residency Program’s Global Medicine elective.

UC San Diego’s visiting faculty and residents have helped UEM adopt academic medical practices such as morning report and teaching conferences that strengthen the educational program.

MEPI biomedical informatics team members at October conference at UEM in Maputo.

MEPI biomedical informatics team members at October conference at UEM in Maputo.

The MEPI partnership relies heavily on biomedical informatics to accomplish its goals. This component of the program is led by Lucila Ohno-Machado, MD, PhD, Professor of Medicine and Chief of UC San Diego’s Division of Biomedical Informatics. The division will provide expertise for the partnership’s information technology projects.

Dr. Kathy Promer, a 2013 graduate of the UC San Diego Internal Medicine Program, is the current infectious diseases fellow at UC San Diego on rotation at UEM’s Maputo Central Hospital. In the photo below, she is standing, second from the right.

Dr. Kathy Promer (standing, second from the right), 2013 Graduate of the UCSD Internal Medicine Program and current infectious diseases fellow at UCSD on rotation at UEM’s Maputo Central Hospital.

Smartphones and iPad mobile digital devices have been deployed on the wards at Maputo Central Hospital, UEM’s primary teaching hospital and the only tertiary care center in Mozambique. With these devices, the Mozambican doctors are able for the first time to consult online medical literature at a patient’s bedside. Soon they will have immediate access to data generated by the hospital’s clinical laboratories.

“These efforts really have changed the character of the residency program at Maputo Central Hospital,” said Dr. Schooley.

Through training and partnership with UC San Diego, UEM will also increase its capacity to do operational, epidemiological, translational and clinical research. Another program goal calls for UEM to set up a biomedical informatics infrastructure and connect with SEACOM, the new fiber optic broadband internet service in South and East Africa.

Students in UEM medical school class.UEM will also take steps to enhance its support of two new medical schools recently established by the Mozambican government in Nampula and Tete. These two new medical schools were launched in the past 3 years to address the profound shortage of physicians in the country.

Another key UC San Diego figure in the project is Stephen Bickler, MD, who will work to improve the nation’s surgical capacity in rural areas via a linked MEPI project, “UEM-UCSD Surgery Partnership.” Dr. Bickler is Associate Professor of Surgery and Pediatrics.

A number of other UC San Diego faculty members will contribute to the MEPI effort as well.

Medical school class   UCSD internal medicine resident Dr. Bethany Karl

Above left, a medical school class at Universidade Eduardo Mondlane. Right, Dr. Bethany Karl on rotation at UEM’s Maputo Central Hospital. Dr. Karl graduated from the UC San Diego Internal Medicine Program in 2010 and is currently a nephrology attending. Photo courtesy of Robert T. Schooley, MD

Project leaders expect to double the number of graduating doctors in Mozambique in the next 10 years. They also hope to inspire more doctors to devote their careers to medical education.

With a greater number of highly-trained doctors and a better infrastructure to support them, Mozambique will increase its capacity to deliver health care to its citizens and to fill the faculties of two new medical schools in Nampula and Tete.

The doctors training today in Mozambique will be the specialists, medical school faculty members, and government Ministry of Health policymakers of the future.

“We hope this will be a demonstration project for the rest of Africa,” Dr. Schooley said.

Read the UC San Diego News press release about our MEPI project.

Read about the project in “The Great Beyond,” Nature magazine’s blog
for breaking news in the sciences.


Photo Captions and Credits:

Dr. Emilia Virginia Noormahomed, co-principal investigator on the UCSD-UEM MEPI project.Dr. Emilia Virginia Noormahomed, co-principal investigator on the UC San Diego-UEM MEPI project. Photo courtesy of William M. Detmer, MD, MSc.

Drs. Detmer, Tomás, and PatelDr. Bill Detmer, left, demonstrates iPad mobile digital device preloaded with medical programs for doctors’ use in the hospital. Dr. Manuel Joaquim Tomás is at center and Dr. Sam Patel at right. Sam Patel, MD, co-investigator on the MEPI project, is Professor of Medicine at UEM and UC San Diego. William M. Detmer, MD, MSc, a MEPI project consultant, is Assistant Adjunct Professor of Clinical Informatics at the University of Virginia and President and Chief Executive Officer of Unbound Medicine. Photo courtesy of Dr. Detmer.

Dr. Tilghman and Mozambican residentM. Wilson Tilghman, MD, UC San Diego’s on-site faculty member in Mozambique, consults with a UEM internal medicine resident at a patient’s bedside. Instituting the use of wirelessly-accessed medical reference material in the hospital is one of the UC San Diego-UEM project goals. Photo courtesy of Robert T. Schooley, MD.

MEPI biomedical informatics team members at October conference at UEM in Maputo. MEPI biomedical informatics team members at October conference at UEM in Maputo. From left: Lucila Ohno-Machado, MD, PhD; Eli Aronoff-Spencer, MD, senior postdoctoral fellow in infectious diseases at UC San Diego; Eng. David Bila, Network Director for the Informatics Center at UEM; Heimar de Fátima Marin, RN, PhD, Professor of Health Informatics at Universidade Federal de São Paulo; and Eng. Francisco Mabila, Director of the Informatics Center at UEM. Photo courtesy of William M. Detmer, MD, MSc.

Dr. Kathy Promer (standing, second from the right), is a 2013 graduate of the UC San Diego Internal Medicine Program and is the current infectious diseases fellow at UC San Diego on rotation at UEM’s Maputo Central Hospital.

Students in a medical school class at UEM.Students in a medical school class at UEM. Photo courtesy of William M. Detmer, MD, MSc.

A medical school class at UEM.A medical school class at UEM. Photo courtesy of William M. Detmer, MD, MSc.

UCSD internal medicine resident Dr. Bethany Karl on rotation at UEM’s Maputo Central Hospital.UC San Diego internal medicine resident Dr. Bethany Karl on rotation at UEM’s Maputo Central Hospital. Photo courtesy of Robert T. Schooley, MD.

Trademark Credit Notices:

iPad is a trademark of Apple Inc., registered in the U.S. and other countries.

Remote Italian Village Could Harbor Secrets of Healthy Aging

Researchers will examine 300 Italian residents, all over 100 years old —

The average life expectancy in the United States is approximately 78 years old. Americans live longer, with better diets and improved health care, than ever before, but only 0.02 percent will hit the century mark.

To understand how people can live longer throughout the world, researchers at University of California, San Diego School of Medicine have teamed up with colleagues at University of Rome La Sapienza to study a group of 300 citizens, all over 100 years old, living in a remote Italian village nestled between the ocean and mountains on the country’s coast.

“We are the first group of researchers to be given permission to study this population in Acciaroli, Italy,” said Alan Maisel, MD … Read the Full Story from the UC San Diego Newsroom

Altman Clinical and Translational Research Building Makes Its Debut

New structure will be campus hub for advancing basic science to clinical applications —

Rising above Interstate 5 on the east campus of UC San Diego, the Altman Clinical and Translational Research Institute Building (ACTRI) officially opened its doors Friday in a ribbon-cutting ceremony under blue skies.

The new seven-story building of steel, glass and grooved concrete is home to the Clinical and Translational Research Institute (CTRI) at UC San Diego, established in 2010 as part of a national consortium of 60 medical research institutions created to energize bench-to-bedside efforts. … Read the Full Story from the UC San Diego Newsroom

Complex Health Issues of Aging Patients Not Solved in a Senior Moment

Program teaches medical professionals how to address obstacles to care, such as isolation and homelessness —

Reams of medical books and guidelines exist on how to manage a patient’s diabetes, but much of that goes out the window when your patient is a 70-year-old homeless man eating out of a trashcan.

“There’s no point in simply giving this patient insulin and telling him to get on a restricted diet,” said Dr. Diane Chau, associate professor of medicine at UC San Diego School of Medicine and a physician at Veteran Affairs San Diego Healthcare System. “We need to intervene in a broader, more comprehensive way.” … Read the full story from the UC San Diego Newsroom


Forty-One Department of Medicine Physicians Named on San Diego’s 2015 “Top Doctors” List

This year’s San Diego Magazine/San Diego County Medical Society Top Doctors list includes 41 Department of Medicine faculty clinicians. View photo gallery

Dr. Tyler Woodell and Dr. Lawrence Ma Receive Arnold P. Gold Foundation’s Humanism and Excellence in Teaching Resident Awards

Dr. Tyler Woodell

Tyler Woodell, MD

Tyler Woodell, MD, left, a senior categorical internal medicine resident, and Lawrence Ma, MD, a fourth-year medicine-pediatrics resident, will receive the Arnold P. Gold Foundation’s Humanism and Excellence in Teaching Resident Award in a ceremony at the UC San Diego School of Medicine on May 15.

The award recognizes Dr. Woodell and Dr. Ma as role models for others in their compassion, dedication and humanism in their approach to patient care.

Dr. Lawrence Ma

Lawrence Ma, MD

“The Gold Humanism and Excellence in Teaching Resident Award is one of the greatest honors that can be bestowed upon a resident,” said internal medicine residency program director Dr. Simerjot Jassal. “Tyler is a beacon of professionalism. I think this is the most important quality a physician can possess.”

Simerjot K. Jassal, MD, MAS, FACP, is clinical professor in the Department of Medicine.

“This is a great honor that is given to only a handful of UC San Diego housestaff each year. Congratulations to both Lawrence and Tyler!” said Lori Wan, MD, director of the Combined Medicine/Pediatrics Residency Program. She is clinical professor of medicine and pediatrics.

Drs. Woodell and Ma were selected in a vote by third-year medical students and each is one of six recipients this year.

After graduating from the UC San Diego Internal Medicine Residency Training Program in June, Dr. Woodell will begin fellowship training in nephrology at Oregon Health and Science University.

Dr. Ma will start a fellowship in geriatrics at Stanford University in July, with the ultimate goal of practicing primary care across the age spectrum.

As award recipients, Dr. Woodell and Dr. Ma become lifetime members of the UC San Diego Gold Humanism Honor Society. One of their first actions as awardees is to speak to the rising third-year medical students at UC San Diego during Clinical Transition Week.

Novel Approach Blocks Amyloid Production in Alzheimer’s Mouse Model

Promises potential early therapeutic intervention —

Offering a potential early intervention for Alzheimer’s disease (AD), researchers at University of California, San Diego School of Medicine and Cenna Biosciences, Inc. have identified compounds that block the production of beta amyloid peptides in mice. The study is reported April 29 in PLOS ONE.

If the results ultimately translate to human treatment, the most promising compound – a peptide dubbed P8 – could be administered to individuals at high risk of developing the disease, long before the tell-tale signs of dementia occur and perhaps with few side effects, due to the compound’s highly specific mode of action. … Read the full story from the UC San Diego Newsroom

UC San Diego Health System, Scripps Health Partner in Hospice Care, Training and Research

UC San Diego Health System and Scripps Health are partnering to provide improved continuity of patient care, fellowship training and research in hospice and palliative medicine. Under a new five-year agreement, Scripps will work with UC San Diego to provide outpatient and inpatient hospice care for UC San Diego patients, allowing UC San Diego physicians to better coordinate post-acute care for patients with chronic illness. The joint fellowship program is the only physician training program of its kind in San Diego County …

… The hospice and palliative medicine training program is an extension of a fellowship that was previously offered through San Diego Hospice. Gary Buckholz, MD, UC San Diego, and Holly Yang, MD, Scripps Health, co-direct the joint fellowship program, which will be housed at UC San Diego beginning in July 2015. The program will engage faculty from both organizations, exemplifying the teamwork required to meet the physical, emotional, social and spiritual needs of palliative care and hospice patients and their families. … Read the full story from the UC San Diego Newsroom


Thomas Savides, MD, Named Chief Experience Officer for UC San Diego Health System

Thomas Savides, MD, has been named as the first Chief Experience Officer at UC San Diego Health System. In the newly created role, Savides will be responsible for the strategy, leadership and implementation of the plan to improve the total health care experience of patients, families, providers and staff. … Read the full story from the UC San Diego Newsroom

San Diego’s 2014 Top Doctors List Includes 44 from Department of Medicine

Forty-four physicians from the Department of Medicine are among over 100 UC San Diego Health System doctors named to the 2014 San Diego Top Doctors list. See the list for UC San Diego Health System.

Not present on that list are two additional internal medicine physicians who practice at the VA San Diego Healthcare System: Charles Goldberg, MD, and Simerjot Jassal, MD. Dr. Jassal directs the Internal Medicine Residency Program.

The Top Doctors list comes from the annual “Physicians of Exceptional Excellence” survey from the San Diego County Medical Society and San Diego Magazine.

Read the UC San Diego Health System press release